Amsterdam 2015
Menu
AIDSImpact.com
Conference Details
Authors
International Committee
Plenary Speakers
Presenting Speakers
Programme
Sessions
Scientific Committee
Acknowledgements
| Abstract #2088 - Teen spirit: Adolescents and HIV | ||||
|
Session: 46.4: Teen spirit: Adolescents and HIV (Parallel) on Friday @ 09.00-10.30 in C104 Chaired by Tonya Thurman, John Miller Authors: Presenting Author: Dr Massy Mutumba - University of Michigan, United States |
||||
| Additional Authors: | ||||
| Aim: Psychological distress is common among adolescent living with HIV (ALHIV) worldwide, and has been associated with non-adherence to anti-retroviral therapy (ART), leading to poor virologic suppression, drug resistance, and increased risk for AIDS morbidity and mortality. However, only a few studies have explored the relationship between psychological distress and ART adherence among adolescents in sub-Saharan Africa. This paper examined the relationship between psychological distress and ART adherence and assessed the potential mediating role of psychosocial resources. | ||||
| Method / Issue: We conducted a cross-sectional survey of 464 ALHIV (aged 12 – 19 53% female) seeking HIV care at a large HIV treatment center in Kampala, Uganda. ALHIV were recruited during routine clinic visits. Adherence was assessed using a self-report on missed pills in the past 3 days adherence to medical regimen and self-rated adherence using a visual analogue scale (VAS). Psychological distress was assessed using a locally developed psychological distress checklist that was developed and validated for Ugandan ALHIV (internal reliability, a = 0.89). The psychosocial resources assessed included spirituality and religiosity (measured using the Brief RCOPE spirituality subscale), optimism (using future orientation items adapted from the National Longitudinal Study of Adolescent Health), social support (measured using the Social Support Questionnaire), and coping strategies (assessed using the Adolescent Coping Orientation for Problem Experiences scale). Descriptive statistics were computed to examine the distribution of all the variables and bivariate analyses were conducted to examine the relationship (direction and strength) between the predictor variables and each derived indicator of non-adherence. Logistic regressions were conducted to assess the relationship between psychological distress and each indicator of non-adherence- missed pills, following regimen and self-rated adherence. For each adherence indicator, we examined the zero-order association between psychological distress and non-adherence, followed by analysis of the relationship between psychological distress and non-adherence, net of socio-demographic variables, and then examined the mediating effects of psychological resources using the Baron and Kenny method. | ||||
| Results / Comments: The mean age of the sample was 15.6 years (SD = 2.44), 53.4% (n = 249) of respondents were female, and 94% (n = 439) were currently attending school. More than two thirds of respondents were orphaned. The proportions of non-adherent respondents varied across the three indicators: missed pills (81.7%), following regimen (41.4%), and self-rated adherence (58.8%). In the logistic regression analyses adjusting for respondents’ socio-demographic and psychosocial characteristics, psychological distress increased the odds of non-adherence: missed pills (OR = 1.75 CI: 1.04 – 2.95) following medical regimen (OR = 1.63 CI: 1.08 – 2.46) and VAS (OR = 1.79 CI: 1.19 – 2.69). Psychosocial resources partially mediated the relationship between psychological distress and non-adherence across all indicators. | ||||
| Discussion: Study findings underscore the need to strengthen psychosocial aspects of adolescent HIV care. Interventions to identify and address psychological distress are particularly needed. The variation in adherence rates highlights the need for robust adherence measures. | ||||
| Go Back | ||||